Adrenal glands - paired organ
Endocrine glands person located in close proximity to the upper pole of the kidney, the principal function of these structures is the production of hormones in the body (adrenaline, noradrenaline, corticosteroids, sex hormones).
Adrenal cyst - a benign, hollow, hormonally inactive single chamber (less multi-chamber) forming a liquid filled with different localization in the projection of the adrenal gland and is most of the clinically asymptomatic. Adrenal cyst - a rare pathology of the endocrine glands diagnosed randomly during extended ultrasound of the abdominal cavity. When ultrasound adrenal cyst is the kind of education districts or oval with a smooth inner surface and clear smooth contours with echogenic thin walls and anechoic content. Cyst adrenal does not affect the production of hormones and hormonal changes of the patient in general.
Cysts adrenal be of different sizes. In medical practice, were cases when the adrenal cyst greater than 10cm in size. The size of cysts affect the severity of symptoms.
The morphological features distinguish 4 types of cysts of the adrenal glands:
- True epithelial cyst of the adrenal gland - cystic formation, lined with cylindrical epithelium, adrenal cortex or secretory epithelium cells migrated segment of the kidney;
- True endothelial adrenal cyst - cystic formation, resulting from ectasia (extension) of the lymph and blood vessels;
- Parasitic cysts of the adrenal gland - cystic formation is formed as a result of hydatid tapeworm infestation;
- Adrenal pseudocyst is a residual phenomenon after hemorrhage in healthy tissue or a tumor of the adrenal gland. This education has no epithelial lining may be significant.
Adrenal cysts are more common as a single, unilateral cysts. In rare cases diagnosed multiple cystic lesions or bilateral change.
Adrenal cyst: Symptoms and Diagnosis
In the diagnosis of adrenal cyst important stage of research is to determine the malignant neoplasms potential cysts. In a survey of adrenal cyst must be differentiated from other tumors of the adrenal gland and kidney cancer metastasis, okolonadpochechnikovoy aneurysm, retroperitoneal teratoma, liposarcoma. Upon detection of an adrenal cyst diagnosis of education should include the definition of a hormonal background of the patient, x-ray study, magnetic resonance imaging with contrast administration that would eliminate the tumor (cystic formation does not accumulate contrast).
In some cases, closely adjacent to the kidney cysts is probable diagnosis of adrenal cyst as the cyst of the upper pole of the kidney. Reliably recognize the true nature of education is possible with MRI and CT.
Giant cysts diagnosed adrenal difficult. Often these tumors falsely diagnosed as pancreatic pseudocysts, the true diagnosis is made only during the operation.
Adrenal cyst in most cases are asymptomatic. Upon reaching the large adrenal cyst formation may manifest symptoms as follows:
- Increased blood pressure (when squeezed cystic renal artery);
- Pain in the lower back, back, side by destruction of the adrenal gland;
- The feeling of compression in the peritoneum;
- Impaired renal function (for large amounts of education and squeezing of the kidneys).
When the diagnosis of adrenal cyst symptoms will depend on the location and size of education.
Adrenal cyst: treatment, prognosis
Correct diagnosis of suspected adrenal cyst largely determines the treatment of education. As a rule, at a relatively small size (up to 4 cm) adrenal cyst treatment is not required. Such patients show a regular basis (every 6 months) CT monitoring tumors tracking the dynamics of its development. With a significant increase in the adrenal gland cysts increases the risk of complications such as purulent inflammation of the cyst, cyst rupture, internal bleeding.
the time when the treatment of adrenal cyst conservative methods are not practiced. Effective treatment of adrenal cyst used radical methods - cystectomy, partial adrenalectomy.
Cystectomy - radical surgical excision of cysts and shells.
Partial adrenalectomy - removal of benign tumor with maximum preservation of healthy breast tissue. During this surgery is performed urgent review of the drug dissected to determine an adequate level of intervention.
Backing adrenal tissue provides a higher standard of living (stress reaction) and avoids hormone replacement therapy.
Modern techniques of surgery to remove the cyst adrenal involve traditional lumbar access or laparoscopic approach. The choice of treatment of cysts, as well as individual indications for surgical excision of Education jointly determined by the surgeon and endocrinologist.
Indications for removal of the adrenal gland cysts are benign laparoscopic, hormonally inactive cystic formation of small sizes (from 2 to 6 cm) without evidence of invasion into adjacent tissues.
The advantages of endoscopic techniques of surgery to remove the cyst of the adrenal gland are:
- Minimally invasive techniques (the smallest mechanical tissue damage);
- Visualization of the adrenal glands, blood vessels, and tumors of a high magnification;
- Less blood loss than during the operation of a traditional lumbar access;
- Reducing the period of disability, the rapid recovery after surgery;
- Safety and speed of operation.
Laparoscopic technique also carries certain risks:
- Chance of abandonment of the tumors in multifocal lesions of the adrenal gland;
- The increased risk of recurrence of education.
If successful outcome of the operation the prognosis is favorable.